MEDICARE: MRS. NATASHA VALERIE HEITMAN DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	19772	MA

General Provider Information

NPI Number	:	1932477619
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NATASHA VALERIE HEITMAN DPT

Provider Business Mailing Address
First Line	:	525 MASSACHUSETTS AVE
Second Line	:	STE 101D
City	:	ACTON
State	:	MA
Zip	:	01720-2963
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	525 MASSACHUSETTS AVE
Second Line	:	101D STUDIO 4
City	:	ACTON
State	:	MA
Zip	:	01720-2959
Country	:	US
Telephone Number	:	978-795-4066
Fax Number	:	978-224-1034

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2011
Last Update Date	:	05/10/2021

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